Many vets prescribed medication without diagnosis of mental illness

Three in 10 veterans prescribed psychotropic drugs do not have a diagnosis of a mental illness, a new Yale study shows.

Veterans over 65 were much more likely to be prescribed drugs without a psychiatric diagnosis than younger veterans, according to the study to be published in American Journal of Geriatric Psychiatry.

“Older adults are much more vulnerable to drug side effects, so our goal is to ensure they are getting the right medication for the right diagnosis in the safest way possible,” said Dr. Ilse Wiechers, a Robert Woods Johnson Clinical Scholar at the Yale School of Medicine and VA Connecticut Healthcare System and lead author of the study.

“As a geriatric psychiatrist, I kept running into patients with psychiatric drug prescriptions and no diagnosis of mental illness,’’ Wiechers said. “The question was, how often is this happening?”

Wiechers and Yale colleagues Dr. Paul Kirwin and Dr. Robert Rosenheck analyzed outpatient administrative data of 1.8 million veterans. They found that even when considering potential use for medical illnesses, older veterans were still more likely to be prescribed a psychiatric medication without a psychiatric diagnosis.

Wiechers said the results are concerning, but stressed the study could not determine whether the results stemmed from overprescription of drugs, underdiagnosis of mental illness, or incomplete documentation.